Functional limitations and depression after traumatic brain injury: examination of the temporal relationship.
OBJECTIVE
To examine the temporal relationship between self-reported injury-related functional limitations and depressive symptomatology after traumatic brain injury (TBI).


METHODS
A longitudinal cohort study with 3 evaluation points.


METHODS
A level I trauma center.


METHODS
Adolescents and adults (N=135) with complicated mild to severe TBI (72% had complicated mild injuries) who were recruited within 24 hours of injury and then completed the measure at all 3 time points.


METHODS
Not applicable.


METHODS
Sickness Impact Profile and Center for Epidemiological Studies-Depression Scale.


RESULTS
Individuals who reported more depressive symptomatology consistently endorsed more injury-related difficulties, showing the strong relationship between depression and perceived psychosocial functioning. Examination of these relationships over time revealed that increased depressive symptomatology follows higher levels of perceived injury-related changes but that reports of injury-related changes are not associated with earlier depression. These findings suggest a unidirectional temporal relationship between these variables.


CONCLUSIONS
Perceived changes in daily functioning appear to influence emotional well-being over time after TBI. However, depressive symptoms do not appear to negatively impact individuals' perception of later functioning. These results further our understanding of the complicated relationship between these variables and may have important implications for treatment of depression after TBI.
Pagulayan
Kathleen Farrell
KF
Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA. farkat@u.washington.edu
Hoffman
Jeanne M
JM
Temkin
Nancy R
NR
Machamer
Joan E
JE
Dikmen
Sureyya S
SS
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000503:physiopathology* / Q000523:psychology* / Q000534:rehabilitation; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012044:Regression Analysis; D018434:Sickness Impact Profile; D013997:Time Factors